Saturday, June 23, 2018

Allergy
emergency take one: Charles was on vacation in Tuscany when he got stung by a
bee, felt his throat start to close, and headed for the nearest Emergency Room.
They recognized impending anaphylactic shock and knew there’s only one way to
be sure it won’t be lethal: a shot of adrenalin, which starts working in
seconds. The docs gave him the injection, Charles felt better, he stayed under
observation the rest of the afternoon, he went home with a prescription for a
few days of pills. Ordinary modern medical care.

Allergy emergency take two:
Margherita knew she was horribly allergic to nuts. The scoop for her coffee and
coconut gelato must have been dipped first in hazelnut or walnut flavor,
because she felt her chest begin tightening up. Off to her local hospital,
where things started going sideways. The head of the Emergency Room didn’t
believe in adrenalin. So his staff gave her only a shot of cortisone, which
doesn’t start to have an effect for hours. By the time the medication did kick
in Margherita was struggling to breathe. She was lucky, and survived to tell me
the tale.

In the first decades I worked here
the anti-adrenalin school held sway in Italian Emergency Rooms, at least those
within range of Rome. By now things have improved considerably, and most
patients who need it do get that magic injection of adrenalin in the Emergency
Room.

But though we’re well into the 21st
century, I’d estimate that the bad old
policy still holds sway at about one ER out of six – which means Russian
Roulette for anyone who might be going into anaphylactic shock. One of those
eternal Italian mysteries, like why secretaries always tell you to call back
instead of taking a message.

Last
month a patient provided a scary new twist on the allergy theme: when her
throat started closing up at 3 am she rushed to an ER, walked up to the glass
barrier with her head tipped backward (the only way any air could get in), and
told the triage nurse she couldn’t breathe. The nurse told her to go sit in the
waiting room. Three hours later she and all the 15 other supplicants hadn’t
seen the shadow of a doctor. Since her throat still hadn’t closed altogether my
patient figured she’d live, and went home.

Moral
of the story: if you’re visiting Italy and know you have a potentially
life-threatening allergy, be sure you bring along an up-to-date Epipen. Locals
can obtain the equivalent free at
public hospitals, but it can be very difficult to find one being sold in
regular pharmacies.

Monday, June 18, 2018

In the days before
there were fixed airport rates and before all New York cabs were driven by
foreigners who can’t tell Brooklynese from a southern drawl, I used to ratchet up my
native Noo Yawk accent when climbing into a cab at JFK, to let the
driver know I was a local and thus avoid being chiseled. Not good enough: once
I was so sleepy heading to midtown Manhattan at 3 AM I didn’t notice I was
being driven all along the Brooklyn seashore, doubling both the mileage and the
tab.

But when it comes to fleecing
passengers, Rome
cabbies take the prize. A team of investigative reporters in the 1990s found
that half the foreigners who take a taxi from the Da Vinci airport in Fiumicino
got cheated. Nobody wasted gas on extra mileage like my New York cabbie – they’d
just tell a packed cab that the meter rate was per person. Legit cabbies can’t
pull that trick now that they have to post their rates in four languages, but tourists
emerging from International Arrivals still run a gauntlet of unlicensed swindlers
muttering “Taxi? Taxi?”

One taxi driver confided to me on the long drive to
the airport that before taking off for a vacation elsewhere in Italy he always
checked out ahead of time what the cab fares were supposed to be at his destination, assuming
that his colleagues there would try to rip him off.

I once went to the American
Embassy to plead an employee’s compensation case in front of a State Department
lawyer who had been flown in from the States for the occasion. The lawyer had obediently
followed the Department’s penny-pinching guidelines and taken a bus to town
from the airport instead of spending 25,000 lire on a cab. When he got out at
the bus station, he told me, he took a taxi straight to the Embassy half a mile
away – had the 30,000 lire he’d paid been the right price? I had to break the
news that on the meter it would have been about 3,000. His round pink innocent
face had “Take me for a ride” written all over it.

But this is Italy, so you
never know – another time the meter reads €10.50 and the cabbie says
just give me ten.

Visitors take note: Italian cabbies don’t expect tips! And the
fixed rates from Rome’s airports into town include your luggage!

Wednesday, June 6, 2018

The book I’ve been working on for
more than 30 years, about my adventures practicing medicine in Rome, has been
accepted for publication!!! Paul Dry
Books in Philadelphia, is planning to bring it out in spring 2019 under the
title Dottoressa: An American Woman Doctor In Rome, and hopes to get it
published in Italian some time thereafter. Paul Dry is a wonderful small
independent publishing house, with focus on the intellectual and the quirky,
and I’m proud to be in the company of its authors. The book is entirely
independent of the blog – even assiduous blog fans will find it all new
material.

About Me

I moved to Rome in 1978 after finishing my training in New York, and have been practicing primary care internal medicine there ever since, treating a clientele that’s featured Roman auto mechanics and British ambassadors, Indonesian art restorers and Filipina maids, Russian poets and Ethiopian priests. When not seeing patients, doing research in psychosomatic medicine, or being the Artist's Wife to my composer husband, I've written a book about my medical adventures, Dottoressa: An American Doctor In Rome, to be published by Paul Dry Books in May 2019.